Functional outcomes of decompressive hemicraniectomy following malignant middle cerebral artery infarctions: a systematic review

• Published in: British journal of neurosurgery Vol. 26; no. 3; pp. 310 - 315
• Main Authors: McKenna, Alison, Wilson, Colin F., Caldwell, Sheena B., Curran, David
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.06.2012; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adolescent; Adult; Age Factors; Aged; craniectomy; Decompressive Craniectomy - methods; Decompressive Craniectomy - mortality; Female; functional outcome; Humans; Infarction, Middle Cerebral Artery - mortality; Infarction, Middle Cerebral Artery - surgery; Male; Middle Aged; middle cerebral artery; Neurology; Neurosurgery; Sex Factors; Stroke; Surgical outcomes; Survival analysis; Systematic review; Treatment Outcome; Young Adult
• ISSN: 0268-8697; 1360-046X
• DOI: 10.3109/02688697.2012.654835

Abstract Decompressive hemicraniectomy has been used increasingly in recent years to treat malignant middle cerebral artery territory infarction. This review examines functional outcome data, with the novel analysis of outcomes according to temporal periods post-surgery. Case series data were pooled to determine significant correlates of outcome. Severe disability was frequently the outcome among survivors within one month post-surgery. Time and rehabilitation were later reflected, with fewer deaths and the emergence of mild to moderate disability increasing in prevalence. Mortality and severe disability were consistently more probable with increasing age. Presurgical clinical status in the form of additional cerebral artery involvement and midline shift also correlated with mortality within the 30-day period post-stroke.